Pathology International

Nakamura, Yasuhiro

doi: 10.1111/j.1440-1827.1993.tb01145.xpmid: 8372679

Pulmonary disorders in infants are intimately related to the pulmonary development during the antenatal, neonatal and infantile period. In this review, normal pulmonary development is considered and several pulmonary disorders such as pulmonary hypoplasia, pulmonary sequestration, congenital cystic adenomatoid malformation, hyaline membrane disease, bronchopulmonary dysplasia, Wilson‐Mikity syndrome and perinatal pneumonia are presented in light of the current literature.

Tanaka, Mitsugu; Ishikawa, Tomohisa; Sakaguchi, Masami

doi: 10.1111/j.1440-1827.1993.tb01146.xpmid: 8372680

An immunohistochemical study of HBV‐associated antigen in the liver of 16 Japanese infants with biliary atresia revealed positive findings in 13 of the cases for HBc and/or HBs antigens. The positive cells were mainly small liver cells distributed in the peripheral zone of the lobule, and a few lymphocytes were observed in contact with or around the positive liver cells for HBV‐associated antigen. Again, HBc antigen was demonstrated almost exclusively in the cytoplasm of positive liver cells. As these findings suggest the possibility of destruction and drop‐out of cells constituting the interlobular bile duct in the junctional area by an immunological mechanism, the probability of HBV infection being an important factor in causing and accelerating biliary atresia cannot be denied. Positive findings for HBV‐associated antigen similar to those found in biliary atresia are also seen in neonatal hepatitis and choledochal cysts. These conditions are therefore presumed to belong to the same category.

Nitta, Kosaku; Uchida, Keiko; Tsutsui, Takaaki; Horita, Shigeru; Hayashi, Tetsuo; Ozu, Hiroyuki; Kawashima, Akira; Yumura, Wako; Nihei, Hiroshi

doi: 10.1111/j.1440-1827.1993.tb01147.xpmid: N/A

The chronic administration of cyclosporin A (CyA) could be associated with renal arteriolar damage. Endothelial cell injury is considered to be the first event in this pathological change. Bovine glomerular endothelial cells (GEN) were used to investigate whether CyA induces microvascular injury in vitro. The damage induced by CyA was demonstrated by cell detachment from the culture plate and cell lysis as characterized by the increase in lactate dehydrogenase (LDH) at the same time after CyA treatment. One μol/L of CyA induced detachment of GEN within 3 h and lysis after 6 h. Cyclosporin A‐induced GEN lysis appeared in a dose and time‐dependent manner. These results indicate that GEN are vulnerable to CyA exposure, suggesting that GEN damage might be related to CyA‐mediated glomerular injury.

Iwai, Kazuro; Tachibana, Teruo; Takemura, Tamiko; Matsui, Yasuo; Kitalchi, Masanori; Kawabata, Yoshinori

doi: 10.1111/j.1440-1827.1993.tb01148.xpmid: 8372682

Three hundred and twenty autopsy cases of sarcoidosis during a 32 year period were collected from the Annuals of the Pathological Autopsy Cases in Japan, published yearly since 1958, and from a literature survey. A statistical analysis of these reviewed autopsy cases was carried out on the epidemiological features of the disease and on the causes of death. The proportion of sarcoidosis autopsy cases relative to the total autopsy cases had increased during this 32 year period. The increase of sarcoidosis autopsies during this period was chiefly due to the increase in aged females; the total number of female cases was approximately two times more than that of males. As over half of the total cases had only a pathological diagnosis and not a clinical diagnosis for sarcoidosis, the actual morbidity from sarcoidosis that was estimated from the autopsy data and corrected by autopsy rate was over five times higher than that of the clinically recognized cases. Age and sex distribution of these cases peaked in the thirties for both sexes, while another very high peak was noted in females over 50 years of age. In approximately 60% of the sarcoidosis autopsies, the cause of death related to sarcoid lesions in the heart, lung or nervous system, the majority of which involved cardiac sarcoidosis. In the remaining 40% of the cases, the cause of death was from non‐sarcoidosis diseases.

Iwai, Kazuro; Takemura, Tamiko; Kitaici, Masanori; Kawabata, Yoshinori; Matsui, Yasuo

doi: 10.1111/j.1440-1827.1993.tb01149.xpmid: 8372683

Three hundred and twenty autopsy cases of sarcoidosis in Japan were analyzed to determine the pathological changes in the early stage, the mode of progression in each organ and the changes in the final stage of the disease. The lung and the mediastinal lymph nodes were affected in most of the cases, while the lesions were limited to the lung and intrathoracic nodes in some of the cases. It was suspected that early changes developed in the lung and in the hilar, and then in the mediastinal lymph nodes. The progression of sarcoid granulomas in the lung was classified into three patterns: (i) probably of a disseminated hematogenous nature; (ii) of an interstitial lymphogenous nature; and (iii) of a local expansive nature. These three patterns were observed also in the heart. In the brain, perivascular granuloma formation was a prominent feature. In the other organs in which sarcoid lesions were not malignant nor disseminated and conglomerated, no interstitial patterns were observed. In chronic cases, repeated dissemination and particularly the interstitial spread of granulomatous changes led to a prominent interstitial fibrosis and dysfunction of the organs, finally resulting in death of the individual. In such longstanding cases, the mediastinal nodes deteriorated by hyalinous degeneration of the granulomas, and many active granulomas were formed in the intra‐abdominal or body surface lymph nodes. These lymph nodes were likely to continue supplying sensitized lymphocytes to the whole body. A persistence of active change in the lymph nodes and the lymphogenous spread of granulomas in organs would appear to be key factors in the prognosis of sarcoidosis.

Yokono, Hideki; Hibi, Toshifumi; Fujisawa, Toshiko; Suzuki, Tatsuo; Ohbu, Makoto; Muraoka, Matsuo; Tsuchiya, Masuharu; Hata, Jun‐ichi

doi: 10.1111/j.1440-1827.1993.tb01150.xpmid: 8372684

The phenotypes of B cells and dendritic cells in human thymus were examined immunohistochemically using various monocional antibodies. Normal thymus contained a few B lymphocytes recognized by CD19, CD20, CD22, L26 and LN‐2, which were localized in the medulla. These B cells were negative for LN‐1, L30 and CD11c (Leu M5). Activated B cells recognized by CD23 (B6) and L29 antibodies were not present in normal thymus. Dendritic cells stained by CD11c were weakly positive for L26 and CD20. There was no difference in the distribution of dendritic cells between normal thymus and thymus from the patients. In the thymus from patients with myasthenia gravis, numerous B cells were demonstrated in the medullary area and lymphoid follicles. Activated B cells were seen mainly in the germinal center of lymphoid follicles and were scarce in the medulla. Many B cells were also found in the medulla and lymphoid follicles of the thymus from patients with ulcerative colitis. However most of those B cells were not activated, even in the lymphoid follicles. These results suggest that thymic B cells may contribute to the induction of immune abnormalities in patients with myasthenia gravis and those with ulcerative colitis, however, the mechanisms by which thymic B cells participate in the pathogenesis of these two diseases would be different.

Nakamura, Shigeo; Koshikawa, Takashi; Koike, Koichi; Kitoh, Kuniyoshi; Suzuki, Hisamitsu; Oyama, Atsushi; Motoori, Tadashi; Kojima, Masaru; Ogura, Michinori; Kurita, Soji; Ueda, Ryuzo; Tajima, Kazuo; Takahashi, Toshitada; Suchi, Taizan

Deguchi, Hiroyo; Hamano, Hironori; Hayashi, Yoshio

doi: 10.1111/j.1440-1827.1993.tb01152.xpmid: 8396843

Using an immunohistochemical study and an immunoblot analysis, the expression of cellular oncogenes of the human salivary glands such as c‐myc, ras p21, and p53 tumorsuppressor gene in pleomorphic adenomas and its malignant form, carcinoma in pleomorphic adenomas was examined to evaluate a differential biological significance, in comparison with that in normal salivary gland tissues. Immunohistochemically, the c‐myc product was detected in 42% of the pleomorphic adenomas and in 56% of the carcinomas in pleomorphic adenoma. The ras p21 expression was observed in 24% of pleomorphic adenomas, and in 50% of carcinomas in pleomorphic adenoma. The p53 protein was detected in 18% of the pleomorphic adenomas and in 67% of the carcinomas in pleomorphic adenoma. Although there was no significant difference between the benign and malignant forms for the expression of c‐myc, a statistical significance in ras p21 and p53 expression was found between the pleomorphic adenoma and its malignant form (P < 0.05) and P< 0.001, respectively). An immunoblotting assay clearly demonstrated the expression of c‐myc and p53 gene products in both the benign and malignant forms of the pleomorphic adenoma, and that of ras p21 in the malignant form. These results indicate that activation of c‐myc and ras p21 proto‐oncogenes and the involvement of p53 mutation may play important roles in the malignant transformation of salivary gland pleomorphic adenoma.

Motoyama, Teiichi; Tanikawa, Toshitaka; Watanabe, Hidenobu

doi: 10.1111/j.1440-1827.1993.tb01153.xpmid: 8372686

The clinicopathologic features of two patients with mixed gonadal dysgenesis are presented, with specific reference to the relationship between endogenous sex hormones and the endometrium and the development of neoplastic disease. One patient, whose immature gonad contained granulosa cells and theca cells, had elevated serum estrogen levels and an endometrium with frequent ciliated metaplasia and squamous metaplasia. Another patient had elevated serum testosterone levels and atrophic endometrium. Both had gonadal tumors, more specifically, germinomas, which contained many calcified nodules within the tumor. These findings suggest that these germinomas arose from a gonadoblastoma.

Kashima, Kenji; Yokoyama, Shigeo; Inoue, Souichi; Daa, Tsutomu; Kodama, Masaaki; Nakayama, Iwao; Noguchi, Shiro

doi: 10.1111/j.1440-1827.1993.tb01154.xpmid: 8372687

Two cases of mixed medullary and follicular carcinoma of the thyroid (MFC) and two cases of thyroid carcinoma resembling MFC are reported with a description of their histological and immunohistochemical features. Two cases of MFC with lymph node metastasis were histologically distinguishable from each other because one had a follicular structure filled with a thyroglobulin (TG)‐positive colloid‐like substance and the other did not have it. Although one of the thyroid carcinomas resembling MFC was similar to the case of MFC with a follicular structure in its primary lesion, it showed no lymph node metastasis. The metastatic lesion of the thyroid carcinoma resembling MFC consisted of TG‐ positive cells and neighboring calcitonin (CT)‐positive cells. However the primary lesion exhibited the typical features of papillary carcinoma except for the presence of a small lesion which stained negatively for both TG and CT. The two types of tumor were not intermingled in a single tumor. These cases of thyroid carcinoma resembling MFC have a possibility of being MFC. However they should not be classified as MFC because lymph node metastasis or the coexistence of medullary carcinoma and follicular carcinoma in their primary lesion was not proved.